The progression of Lyme disease differs in each patient, depending on their age, sex, health, and other factors. Patients with existing health problems may be more likely to suffer symptoms connected to those ailments, such as Lyme carditis, Lyme arthritis, or neurological symptoms. Early stage Lyme disease symptoms often subside quickly and may not reoccur at all or may arise months after the initial signs of infection. Late-stage Lyme disease symptoms are often difficult to recognize as being part of a single illness and can be labelled as a variety of differential diagnoses, especially when symptoms do not occur together and are, instead, separated by weeks or months.
Long-Term Lyme Disease Progression
Unchecked Lyme disease progression can cause permanent damage to bodily systems and widespread infection is often more difficult to treat with Lyme disease antibiotics than an earlier infection that is localized. Chronic Lyme disease arising months or even years after infection may occur in patients whose initial symptoms were not identified as being due to a tick bite and transmission of Lyme disease bacteria. A dormant infection with Borrelia can suddenly become active as the bacteria replicate and cause inflammation and tissue damage. Rheumatologic complaints and neurological issues are the primary effects of long-term untreated Lyme disease, with both the central nervous system and the peripheral nervous system at risk of injury.
Lyme Disease Skin Symptoms
The progression of skin symptoms in Lyme disease is subject to some debate with only two specific dermatological complaints, the erythema migrans Lyme disease rash and acrodermatitis chronica atrophicans, attributed to the infection. Other lesions have been connected to the spread of Borrelia bacteria, including morphea (localized scleroderma) in European patients but not in North America patients, based on tests looking for bacterial DNA in these lesions. Lichen sclerosis, eosinophilic fasciitis, and progressive facial hemiatrophy have all been linked to Lyme disease progression in a handful of cases in Europe but there is little clinical evidence to connect these skin symptoms with Lyme infection. Erythema migrans can occur as a small bull’s-eye rash that is seen to grow outwards over a number of days before fading. The rash may be easily missed if the tick bite occurs on the scalp, at the back of the knee, or in another site on the body that is hard to see. The rash may reoccur at sites far from the original tick bite in the following weeks or months, which can cause patients to believe they have been bitten by a number of ticks all at once.
Neurological Lyme Disease Progression
Neurological Lyme disease progression may present as sub-acute encephalopathy, axonal neuropathy, and chronic progressive encephalomyelitis. Patients may be mistaken for having fibromyalgia or even chronic fatigue syndrome, as well as somatoform disorders. Borrelia encephalomyelitis progresses slowly and is a rare effect of late disseminated Lyme disease with severe consequences. Relapses and periods of remittance are common, although a gradual progression is also seen. Varying patterns of weakness in the body, including hemiparesis, ataxia, bladder dysfunction, and seizures, hearing loss, neck stiffness and pain, and cognitive deficits are all potential effects of encephalomyelitis. As the spread and growth of bacterial infection increases, the symptoms of late stage neuroborreliosis include myelitis in around half of patients and spastic paraperesis or quadraperesis may occur.
Lyme Disease Progression and Diagnosis
On occasion, the progression of Lyme disease will lead patients to seek psychiatric help, although the illness does not commence as a psychiatric one and it is likely that early physical symptoms have simply been missed or misdiagnosed. In untreated Lyme disease cases in Europe, neurocognitive symptoms are common but often not well understood. The non-specific nature of the effects of neuroborreliosis can be seen as frightening and bizarre, seemingly defying description under a single illness unless a physician is knowledgeable about Lyme disease. Patients with many different ailments may be seen as hypochondriacs and their physical symptoms, such as pain, fatigue, and tenderness dismissed as a consequence of their psychiatric illness, rather than the symptoms all indicating a physical cause of their suffering. The lack of understanding of such Lyme disease progression can mean that many patients become disenchanted with orthodox medicine and are made vulnerable to approaches from Lyme disease quacks.
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